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California-Licensed Physician Reviewers (M.D., D.O.)-Multiple Specialties

Remote: 
Full Remote
Contract: 
Work from: 
Canada, California (USA), United States

Offer summary

Qualifications:

Current, unrestricted California Medical License, Active Practice Board Certified.

Key responsabilities:

  • Address medical necessity of treatment requests
  • Evaluate medical necessity of denied services
Dane Street, LLC logo
Dane Street, LLC Insurance SME https://www.danestreet.com/
51 - 200 Employees
See more Dane Street, LLC offers

Job description

Dane Street is an Independent Review Organization and a national provider of Utilization Review services (among other offerings) and we are expanding our physician panel resulting in opportunities for non-traditional physician work and supplemental income.  This is a telework opportunity for physicians providing a caseload customized to your schedule.

Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis.

We are looking for the specialties listed below with active California licenses to address the medical necessity of treatment requests and, in appeals, the medical necessity of previously denied services. 

      • Orthopedic Surgery - Spine Surgery
      • Oral Surgery
      • Oral Maxillo-Facial Surgery

The average time spent on most reviews is 15-20 minutes so it is possible to complete several cases within an hour.

Training and onboarding can be completed in less than 1 week and you can start earning compensation for reviews while maintaining your active practice. Contact us today about joining our panel of specialty reviewers!

Requirements

  • Current, unrestricted California Medical License
  • Active Practice
  • Board Certified

Benefits

  • Independent consultant role allows for schedule flexibility and predictable work hours. You choose services and case types, dictate volume, and conduct this work based on your scheduled availability
  • No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions
  • Typical TAT is 1-5 business days depending on the level of review.  Same-day cases are rare but do occur. Dane Street keeps you apprised of required turn-around time and carefully coordinates all administrative tasks so your time is spent on clinical decision-making
  • Dane Street offers a streamlined case flow and a user-friendly work portal. We facilitate all communication, organize and sort all medical records, support all administrative processes, prep cases extensively, and ensure the quality and timely delivery of all determinations/reports
  • A chronological listing of medical records as well as all treatment guidelines used to make a determination are provided in an easy, click-to-view format
  • In cases where peer-to-peer calls are necessary (adverse determinations), Dane Street’s peer coordinators secure provider availability
  • Dane Street offers initial training as well as an ongoing point of contact should you have any questions about completing reviews

Required profile

Experience

Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Time Management

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